公立医院病人安全文化影响因素量表开发及筛选研究

目的 构建病人安全文化影响因素量表,评价量表的信度、效度。方法 收集条目,聘请专家评审,用初始量表进行预调研,修改形成应用版量表。采取整群抽样的方法进行调研。采用SPSS17.0、EXCEL2007对数据进行分析,结合多种统计方法对条目进行分析和筛选;评价量表效度采用因子分析以及量表编制的过程;应用克朗巴赫α系数、分半信度及重测信度评价量表的信度。结果 应用专家咨询法以及统计方法对量表条目进行筛选,得到49个条目。各维度的内部一致性良好（＞0.7）,分半信度和重测信度的结果良好,对量表进行因子分析以及内容效度的评估,结果显示效度指标良好。结论 量表具有较好的敏感性,区分性,独立性,代表性以及一致性,具有良好的信度和效度。

     

医生职业倦怠量表的编制及信效度检验

目的:编制医生职业倦怠量表.方法:通过查阅文献、访谈及专家讨论,建立量表结构,并确定初始量表项目48条.在西安的两所三级甲等医院施测,2次分别选取176和436名医生作为样本.采用项目分析、探索性因素分析、信度分析、验证性因素分析等统计方法对数据进行统计分析.结果:医生职业倦怠量表由六个因素构成:疲劳感、工作能力下降、投入性下降、成就感降低、工作控制感下降以及工作前景.共有30个项目,量表总分与各因素之间的相关系数0.541～0.856(P＜0.001).六个因素的α系数在0.886～0.896之间,总量表的α系数为0.894.验证性因素分析拟合度较高(RESEA=0.062,GFI=0.859,CFI=0.842,IFI=0.851).医生职业倦怠量表总分及各因子分与工作倦怠问卷的总分及各因子分之间具有显著的相关性(P＜0.05).结论:编制的医生职业倦怠量表信度和效度符合心理测量学要求,可以作为医生职业倦怠测量的工具.     

Weis护士职业价值观量表的编译与本土化修订

目的 通过对Weis“护士职业价值观量表（NPVS-R）”的编译和本土化修订,开发适用于黑龙江省地区护士职业价值观测评的本土化量表。方法 对Weis英文版护士职业价值观量表进行回译、编译与本土化修订。采用编译与修订后量表对哈尔滨市三级医院130名护理人员开展调查,采用因子分析法对调查结果的信度效度进行验证。结果 通过探索性因子分析将编译后的NPSV-R量表划分为5个维度（行动主义、社会公正与信任、职业义务、人类尊严、专业精神）、26个条目,问卷总体Cranach’σ系数为0.946,各维度系数均大于0.7,经验证问卷总体信效度良好。结论 编译后护士职业价值观量表具有较好的信度效度,其维度设置符合目标地区护士职业价值观的实际情况,适于对目标地区护士职业价值观的测评。     

符合Rasch模型的高中“遗传与进化”核心概念试卷设计及效果初步分析

以高中"遗传与进化"核心概念为研究载体,设计符合Rasch模型的二阶诊断试卷,用于探查高中学生对"遗传与进化"核心概念的认知情况,运用Winsteps软件对问卷的初测结果进行分析。结果表明:该试卷的总体项目估计误差、分离度、数据—模型拟合指数、信度等都符合测试要求,但试卷的整体难度低于学生能力,极少数项目的拟合指数、误差分析略超出可接受范围,个别项目受其他因素影响,不符合测试的单维性要求。在下一步工作中,需要适当对项目进行修改或删除。     

军队离退休干部保健对象医疗需求问卷信度和效度研究

目的 研究基于顾客价值理论设计的“军队离退休干部保健对象医疗需求调查问卷”的信度和效度。方法 随机抽取200名对象进行调查,信度包括重测信度、评定者间信度和内部一致性信度,效度包括内容效度、结构效度和效标关联效度。结果 问卷的重测信度、评定者间信度良好,全卷折半信度为0.883 4,克伦巴赫阿尔法系数0.920 5,具有良好的内容效度,结构效度理想,效标效度满意。结论 问卷信度良好,效度理想,值得推广应用。     

从临床到基础：硝酸甘油实验性偏头痛大鼠模型信度和效度评价

具有良好信度和效度的动物模型是从实验室到临床转译研究成功的保证,为进一步应用硝酸甘油（glycerol trinitrate,GTN）偏头痛大鼠模型,对其信度和效度进行评价。效度包括表面效度、建构效度、标准关联效度。衡量表面效度的标准是症状同源性。GTN偏头痛大鼠模型行为学表现与人类偏头痛有一定的相似性。建构效度主要指动物模型对理论假说的解释度,GTN模型复制了偏头痛的神经源性炎症及痛觉增敏,具有较好的建构效度。标准关联效度即预测效度主要表现为药理学反应及其在临床的干预实验。GTN模型对典型抗偏头痛药物麦角胺的反应较敏感,但是该模型的预测力效度仍未有效建立。GTN偏头痛大鼠在不同的地区、不同的实验室均已成功复制,表明其有较好的信度。     

临床医生工作要求—资源量表编制及对工作—家庭冲突的影响

目的 初步编制一套临床医生的工作要求—资源测量量表,检验其信度和效度,并探究工作要求—资源模型对工作—家庭冲突的影响。方法 通过问卷调查法收集数据,采用内部一致性信度检验和探索性因子分析检验量表的信度和效度,采用多元阶层线性回归分析方法检验变量之间的相互关系。结果 工作要求—资源量表包含2个维度下的14个测量条目,工作要求、工作资源和整体量表的格朗巴赫一致性系数分别为0.882、0.787和0.773,量表具有良好的结构效度和预测效度,工作要求对工作—家庭冲突（β= 0.445,P＜0.01）具有显著的正向预测作用,工作资源对工作—家庭冲突（β= -0.270,P＜0.01）具有显著的负向预测作用。结论 临床医生工作要求—资源量表具有良好的信效度,同时,较高的工作要求会更容易引发医生的工作—家庭冲突,而高水平的工作资源则会有效缓冲他们的工作—家庭冲突。     

基于结构方程模型的医患互动关系二元评价模型构建

目的 构建基于医方视角下的支持性互动关系与抑制性互动关系的二元评价模型,并开发相应的测量量表。方法 问卷收集786份医护样本,采用探索性因子分析和验证性因子分析进行模型构建与测量工具开发。结果 医方视角下的医患互动关系模型包含支持性与抑制性互动二元维度;支持性互动关系Cronbachs’ɑ 系数为0.93,抑制性互动关系的Cronbachs’ɑ 系数为0.77;χ²=136.023,χ²/ df=1.679,RMSEA=0.042,GFI =0.956,AGFI =0.935,CFI =0.982,NFI =0.958,模型拟合指标良好。结论 测量模型具有良好的一致性信度和构建效度,医患互动关系是评价医方对医患关系质量认知的重要组成部分与影响因素,构建的二元模型与量表对于测量医患互动关系具有积极的理论意义与实践价值。     

脑卒中患者满意度量表中文修订版的信效度检验研究

目的 构建有良好测量学属性的中文版本的脑卒中患者满意度量表,适用于对中国脑卒中患者的医疗服务满意度进行测量。方法 从上海市5家综合医院中随机抽取300位脑卒中患者进行问卷,得到280份有效问卷,回收率93.3%。运用主成分分析、KM0检验和巴特利球体检验及因子分析对量表进行测评,以此获得量表的信效度。结果 条目分析将条目16剔除;KMO指数为0.854,探索性因子分析验证量表修订版也包括两个因子：住院治疗服务满意度和居家康复服务满意度,两因子解释总变异的70.1%;验证性因子分析验证量表的各项拟合指标良好。中文版本脑卒中患者满意度量表得分总数与医疗服务满意度总分数显著正相关,与Barthel日常生活功能评估指数得分和自我健康功能评估得分低程度显著正相关。总量表的Cronbach’s α系数为0.85,重测信度系数为0.83。结论 中文版本的脑卒中患者满意度量表信度和效度均良好,适用于国内脑卒中患者进行满意度的专门测量。     

大学毕业生心理弹性问卷的初步编制

目的:编制适合中国大学毕业生心理弹性的问卷,为测量大学毕业生心理弹性提供有效工具.方法:对辽沈地区5所高校553名学生进行施测,检验问卷信、效度.结果:该问卷具有5个因素即人际交往能力、自我效能感、情绪控制能力、挑战性、自我管理能力,累积解释率为51.917%,一共44题组成.问卷内部一致性信度在0.732-0.912之间,分半信度在0.728-0.878之间.结论:I'1卷的总分与各个维度之间的相关在0.760-0.832之间,具有较高的信度、效度,是测量大学毕业生心理弹性的有效工具.     

Factor structure of the Brazilian version of Pediatric Daytime Sleepiness Scale

The present study aimed to analyze the construct validity of the Pediatric Daytime Sleepiness Scale (PDSS) for the evaluation of the daytime sleepiness construct in adolescents through confirmatory factorial analysis. The cross-sectional study was carried out with a sample of 773 adolescents aged 14 to 19 years, enrolled in the state schools of Paranaguá, Paraná, Brazil. We investigated the sex, age, school year, study shift, occupational status, socioeconomic level and daytime sleepiness. The PDSS questions were not normal (p <0.001) and the mean total score was 14.87 (5.62). With Schwarz’s BIC adjustment indicators = 142,389 and Akaike’s AIC = 105,389, the model reached the criteria of the global adjustment indicators of the model in the confirmatory analysis, in which RMSEA = 0.020; CFI = 0.986; TLI = 0.977; SRMR = 0.021, with 17 degrees of freedom, KMO = 0.8504 and Cronbach’s Alpha = 0.737, with three correlations. We conclude that the construct validity of the PDSS remains valid and confirms its factor structure with only one factor. Thereby, it was verified that the operationalization of the construct sleepiness of adolescents through this scale is adequately conceptualized to the behavior of the age group.     

Reliability and validity of the Ethiopian version of the hospital anxiety and depression scale (HADS) in HIV infected patients

Background

The hospital anxiety and depression scale (HADS) is a widely used instrument for evaluating psychological distress from anxiety and depression. HADS has not yet been validated in Ethiopia. The aim of this study was to evaluate the reliability and validity of the Amharic (Ethiopian language) version of HADs among HIV infected patients.

Methods

The translated scale was administered to 302 HIV/AIDS patients on follow up for and taking anti-retroviral treatment. Consistency assessment was conducted using Cronbach''s alpha, test-retest reliability using intra-class correlation coefficients (ICC). Construct validity was examined using principal components analysis (PCA). Parallel analysis, Kaiser''s criterion and the scree test were used for factor extraction.

Results

The internal consistency was 0.78 for the anxiety, 0.76 for depression subscales and 0.87 for the full scale of HADS. The intra-class correlation coefficient (ICC) was 80%, 86%, and 84% for the anxiety and depression subscales, and total score respectively. PCA revealed a one dimensional scale.

Conclusion

This preliminary validation study of the Ethiopian version of the HADs indicates that it has promising acceptability, reliability and validity. The adopted scale has a single underlying dimension as indicated by Razavi''s model. The HADS can be used to examine psychological distress in HIV infected patients. Findings are discussed and recommendations made.     

Development of the Assessment of Belief Conflict in Relationship-14 (ABCR-14)

Purpose

Nurses and other healthcare workers frequently experience belief conflict, one of the most important, new stress-related problems in both academic and clinical fields.

Methods

In this study, using a sample of 1,683 nursing practitioners, we developed The Assessment of Belief Conflict in Relationship-14 (ABCR-14), a new scale that assesses belief conflict in the healthcare field. Standard psychometric procedures were used to develop and test the scale, including a qualitative framework concept and item-pool development, item reduction, and scale development. We analyzed the psychometric properties of ABCR-14 according to entropy, polyserial correlation coefficient, exploratory factor analysis, confirmatory factor analysis, average variance extracted, Cronbach’s alpha, Pearson product-moment correlation coefficient, and multidimensional item response theory (MIRT).

Results

The results of the analysis supported a three-factor model consisting of 14 items. The validity and reliability of ABCR-14 was suggested by evidence from high construct validity, structural validity, hypothesis testing, internal consistency reliability, and concurrent validity. The result of the MIRT offered strong support for good item response of item slope parameters and difficulty parameters. However, the ABCR-14 Likert scale might need to be explored from the MIRT point of view. Yet, as mentioned above, there is sufficient evidence to support that ABCR-14 has high validity and reliability.

Conclusion

The ABCR-14 demonstrates good psychometric properties for nursing belief conflict. Further studies are recommended to confirm its application in clinical practice.     

A Community-Based Validation Study of the Short-Form 36 Version 2 Philippines (Tagalog) in Two Cities in the Philippines

Objective

To evaluate the validity and reliability of the Philippines (Tagalog) Short Form 36 Health Survey version 2 (SF-36v2^®) standard questionnaire among Filipinos residing in two cities.

Study Design and Setting

The official Philippines (Tagalog) SF-36v2 standard (4-week recall) version was pretested on 30 participants followed by formal and informal cognitive debriefing. To obtain the feedback on translation by bilingual respondents, each SF-36v2 question was stated first in English followed by Tagalog. No revisions to the original questionnaire were needed except that participants thought it was appropriate to incorporate "po" in the instructions to make it more polite. Face-to-face interviews of 562 participants aged 20-50 years living in two barangays (villages) in the highly urbanized city of Makati City (Metro Manila) and in urban and rural barangays in Tanauan City (province of Batangas) were subsequently conducted. Content validity, item level validity, reliability and factor structure of the SF-36v2 (Tagalog) were examined.

Results

Content validity of the SF-36v2 was assessed to be adequate for assessing health status among Filipinos. Item means of Philippines (Tagalog) SF-36v2 were similar with comparable scales in the US English, Singapore (English and Chinese) and Thai SF-36 version 1. Item-scale correlation exceeded 0.4 for all items except the bathing item in PF (correlation: 0.31). In exploratory factor analysis, the US two-component model was supported. However, in confirmatory factor analysis, the Japanese three-component model fit the Tagalog data better than the US two-component model.

Conclusions

The Philippines (Tagalog) SF-36v2 is a valid and reliable instrument for measuring health status among residents of Makati City (Metro Manila) and Tanauan City (Province of Batangas).     

Development of the Chinese Family Support Scale in a Sample of Chinese Patients with Hypertension

Background

Despite strong recommendations to involve family social support in hypertension control, few questionnaires have been designed to measure family support in Chinese patients. The Chinese Family Support Scale is a self-rated questionnaire that assesses family support over a 6-month period.

Methods

A total of 282 patients with hypertension participated in this study and 136 of them completed the questionnaire twice within an interval of two to three weeks. Exploratory factor analysis was conducted to assess the structural validity of the scale. Concurrent validity was determined by measuring the correlation between the Chinese Family Support Scale, and Hospital Anxiety and Depression Scale using the Sperman’s Correlation Coefficient. Cronbach’s alpha and intraclass correlation coefficients were employed to evaluate the internal and test-retest reliability of the scale.

Results

Exploratory factor analysis revealed a three-factor solution accounting for 62% of the total variance. The three underlying sub-scale dimensions were kinship, nuclear family, and social resources. Significant correlation (r=-0.266; p<0.01) was found between the depression subscales of the Hospital Anxiety and Depression Scale and the extent of support perceived by the patients as measured by the Chinese Family Support Scale. The Chinese Family Support Scale had an acceptable internal consistency (Cronbach’s alpha = 0.84) and test-retest reliability (intraclass correlation coefficient = 0.82).

Conclusion

The study provides preliminary evidence that the12-item Chinese Family Support Scale is acceptable, valid and reliable for measuring the perceived family support in hypertension patients. It is a promising tool which can be easily incorporated into epidemiological surveys.     

Ontwikkeling van de Gedragsobservatieschaal Psychomotorische therapie voor demente ouderen (GPMT-dem).

PDevelopment of the Behaviour observation scale for Psychomotor Therapy for elderly people with dementia (BPMT-dem).Reliability and concurrent validity This article describes the development of the Behaviour observation scale for Psychomotor Therapy for elderly people with dementia (BPMT-dem). This scale was developed in the late 1980s in order to evaluate the effect of psychomotor group therapy on the cognitive, social, and emotional functioning of elderly people with dementia within the therapy situation. The currently described research investigates inter-assessor reliability and internal consistency of the ten subscales (such as memory, orientation, contact with others, initiative, anxious behaviour, aggressive behaviour) and three domains, as well as the scale’s correlation with other observation scales (concurrent validity) in two different patient groups. The first group consisted of clients receiving psychomotor therapy in a nursing home or a psychiatric hospital (N = 130). Inter-assessor reliability (Cohen’s kappa) varied between 0.27 and 1.00, the internal consistency of the subscales (Cronbach’s alpha) was calculated between 0.46 and 0.86, and that of the domains between 0.76 and 0.81. Based on the findings of this study 15 of the original 88 items were removed, 5 items were moved to other subscales and the text of 2 items was changed. Next, the subscale internal consistency and concurrent validity of this modified (73-item version) BPMT-dem was investigated in a group of 41 elderly participating in a support programme in meeting centres for elderly people with dementia and their caregivers. Cronbach’s alpha for the subscales in this study was calculated between 0.47 and 0.86. To determine concurrent validity, the BPMT-dem was compared with (subscales of) the Assessment Scale for Elderly Patients (ASEP), Behavioural assessment for Intramural Psychogeriatrics (BIP), Brief Cognitive Rating Scale (BCRS) and the Cornell Scale for Depression in Dementia. Correlations with related BPMT-dem subscales varied between 0.38 and 0.75. The inter-assessor reliability and concurrent validity of the 73-item version of the BPMT-dem are satisfactory. The internal consistency of 6 subscales is sufficient, and recommendations are proposed to improve the consistency of the remaining subscales. Further research to test the unidimensionality and scalability of the subscales of the BPMT-dem, as well as the effect of the recommended reformulation and removal of items, is recommended. Before the instrument can be used in actual practice, the psychometric qualities of the BPMT-dem73 need to be studied in a larger and in terms of severity of dementia more heterogeneous study sample, so that statements can also be made on which norms to use in various subgroups of elderly with dementia. Tijdschr Gerontol Geriatr 2007; 38: 88-99     

Development and Validation of a New Questionnaire Assessing Quality of Life in Adults with Hypopituitarism: Adult Hypopituitarism Questionnaire (AHQ)

Objective

To develop and validate the Adult Hypopituitarism Questionnaire (AHQ) as a disease-specific, self-administered questionnaire for evaluation of quality of life (QOL) in adult patients with hypopituitarism.

Methods

We developed and validated this new questionnaire, using a standardized procedure which included item development, pilot-testing and psychometric validation. Of the patients who participated in psychometric validation, those whose clinical conditions were judged to be stable were asked to answer the survey questionnaire twice, in order to assess test-retest reliability.

Results

Content validity of the initial questionnaire was evaluated via two pilot tests. After these tests, we made minor revisions and finalized the initial version of the questionnaire. The questionnaire was constructed with two domains, one psycho-social and the other physical. For psychometric assessment, analyses were performed on the responses of 192 adult patients with various types of hypopituitarism. The intraclass correlations of the respective domains were 0.91 and 0.95, and the Cronbach’s alpha coefficients were 0.96 and 0.95, indicating adequate test-retest reliability and internal consistency for each domain. For known-group validity, patients with hypopituitarism due to hypothalamic disorder showed significantly lower scores in 11 out of 13 sub-domains compared to those who had hypopituitarism due to pituitary disorder. Regarding construct validity, the domain structure was found to be almost the same as that initially hypothesized. Exploratory factor analysis (n = 228) demonstrated that each domain consisted of six and seven sub-domains.

Conclusion

The AHQ showed good reliability and validity for evaluating QOL in adult patients with hypopituitarism.     

Psychometric Properties of the Problem Areas in Diabetes (PAID) Instrument in Singapore

Background

Emotional distress is an important dimension in diabetes, and several instruments have been developed to measure this aspect. The Problem Areas in Diabetes (PAID) scale is one such instrument which has demonstrated validity and reliability in Western populations, but its psychometric properties in Asian populations have not been examined.

Methods

This was a secondary analysis of data from patients with Type 2 diabetes mellitus recruited through convenience sampling from a diabetes specialist outpatient clinic in Singapore. The following psychometric properties were assessed: Construct validity through confirmatory factor analysis (CFA) and Rasch analysis, concurrent validity through correlation with related scales (Kessler Psychological Distress Scale, Diabetes Health Profile—psychological distress, Audit of Diabetes Dependent Quality of Life), reliability through assessment of internal consistency and floor and ceiling effects, and sensitivity by estimating effect sizes for known clinical and social functioning groups.

Results

203 patients with mean age of 45±12 years were analysed. None of the previously published model structures achieved a good fit on CFA. On Rasch analysis, four items showed poor fit and were removed. The abridged 16-item PAID mapped to a single latent trait, with a high degree of internal consistency (Cronbach ɑ 0.95), but significant floor effect (24.6% scoring at floor). Both 20-item and 16-item PAID scores were moderately correlated with scores of related scales, and sensitive to differences in clinical and social functioning groups, with large effect sizes for glycemic control and diabetes related complications, nephropathy and neuropathy.

Conclusion

The abridged 16-item PAID measures a single latent trait of emotional distress due to diabetes whereas the 20-item PAID appears to measures more than one latent trait. However, both the 16-item and 20-item PAID versions are valid, reliable and sensitive for use among Singaporean patients with diabetes.